/ 13 August 2009

Night-side of life

A trip to Gabon is just the right thing for some travellers. Like smokers.

You can puff in the airport lounge, waiting for your delayed flight and watching small aircraft of bizarre airlines — Air Services, Air Max, Alafia, Goliaf, Trans Air Cargo — banned from European airspace, unsafe at any speed, even stationary.

For others, a trip out of Gabon is just what the doctor ordered. On Friday July 31, South African Airways Flight 87 carried a young African man on medical evacuation to Johannesburg. Paralysed from the neck down as a result of a spinal trauma, the cabin crew told me. He should have travelled on the 26th but that plane could not fit a gurney.

Three rows of seats were folded down at the back of the plane and a narrow stretcher anchored in midair to a contraption of steel bars, with an amber drip hanging below the overhead compartment.

The young man was covered with two sheets and strapped to the gurney, his neck and chin held by a restraint.

Only the top part of his face emerged — eyes darting in anguish his only movement. He was a bundle of fear and hope with, I wished, a strong sedative in that drip. If take off and landing can be ghastly for the healthy, how is it if you can’t move?

SAA 87 is a midnight-to-dawn five-hour flight but I could not sleep at all. The young man weighed heavily on my heart. Was he afraid? In pain? Dreaming of swimming?

”Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship in the kingdom of the well and in the kingdom of the sick,” wrote Susan Sontag.

The young man recalled our dual citizenship and our final destination. He was a living memento mori (remember you shall die) for all passengers, each carrying our bundles of hopes, fears, regrets and memories as we soared through the night. Below were Central Africa’s majestic rivers and rainforests. On board, our shared frailty.

I want to tell the young man about Jean Dominique Bauby, who was paralysed except for his left eye and dictated, blinking for each letter, a beautiful book, The Diving Bell and the Butterfly. A chant to life, the book became a dazzling movie by Julian Schnabel.

Bauby: ”My diving bell becomes less oppressive, and my mind takes flight like a butterfly.” I wonder if the young man’s mind is gliding. During turbulence, I check on him. He is asleep. I want to stroke his head as you do for a child with nightmares. I don’t dare.

Aircraft are a weird space where people are enclosed for many hours yet remain separate, each in a bubble. For many hours we eat, drink, scratch, squirm and sleep — a most private activity — and never talk to the person next to us.

Many don’t even bother with a greeting when they plonk their bodies next to you. Or they look surprised when you say hello. Basic courtesy has vanished with mass air travel.

As we boarded, a small, squat man gripped by air rage yelled to a woman who apparently had stepped on his seat: ”You fucking white cunt, you bitch.” Then he saw the young man and shut up.

Queuing for the toilet, passengers averted their gaze discreetly from the young man. I could sense a general discomfort, a mix of survivor’s guilt, memento mori, aircraft bubble syndrome and the barriers imposed by modern medicine between the sick and the healthy.

That very morning I had been at the Dr Albert Schweitzer Hospital in Lambaréné, 300km west of Libreville, the capital. Schweitzer’s creative idea was to welcome the African family into the hospital with areas to sleep, cook and wash.

Yvette Boko boarded the taxi-brousse in Libreville in tears about her husband in Lambaréné who needs a graft on an ulcerous thigh. She dashed into Surgery Block 2: ”Mon chéri, I missed you so much!” and got right into bed with him. They looked so happy.

Liz Portnoy, an American medical intern at the hospital, told me: ”In American medicine we don’t see the patient, we see a disease and go at it with a battery of tests. Here, you treat the person.”

While Yvette curled up in bed with her husband, the young man travelled as alone as a lone astronaut in his capsule, as a diver in his diving bell, flying to the best medical technology on the continent, to hope.

During one of Angola’s war waves in the late 1990s, I visited the hospital in Kuito-Bie. That morning an old peasant had been brought in, his head shattered by a landmine, beyond help. The nurses put him in a bare room under a clean sheet. Nobody knew his name. Maybe his family had fled to the safety of Luanda. He was dying alone, with as much dignity as a hospital in a war zone could offer.

The relief plane was leaving in two hours. I stopped reporting and held his hand for as long as I could without missing my flight. His breathing calmed. It seemed like the right thing to do, as a human being, to hold hands with another as life as we know it leaves him.

Ten years later I remembered the old man as I held my mother’s hand in Montevideo, as her body turned cold and her laboured breathing slowed down, then stopped. She wanted to die at home and we managed, with two nurses, to avoid an impersonal hospital death.

I wish I had stroked the young man’s head on flight SAA87. I wish I’d had the courage to break my aircraft bubble. I wish I had reached into his kingdom.

Back in Pretoria I stopped by the Gabonese embassy. It did not know the young man. If a reader knows his whereabouts, please call the paper. I have a DVD of The Diving Bell for him.